181例腹股沟疝普理灵网片前路修补经验

Experience in 181 Cases of Hernioplasty with Prolene Mesh

对成人腹股沟疝人工网片修补的技术问题进行总结和探讨。方法:1997年1月～2002年8月间对181例腹股沟疝病人采用普理灵(Prolene,聚丙稀纺织纤维)网片进行无张力修补,手术方法包括Rutkow手术、Lichtenstein手术、“三明治”式手术和Gilbert手术。结果:181例共行无张力疝修补200例次,其中Rutkow手术162例次,Lichtenstein手术平片修补10例次,“三明治”式修补11例次,Gilbert手术17例次。其中有双侧同期修补19例。1例术后2d后死于脑血管意外;阴囊血肿5例。150例病人随访8个月以上,1例术后3个月出现阴囊鞘膜积液,2例术后残留腹股沟区疼痛超过2个月,无一例复发。结论:人工网片修补是治疗腹股沟疝的有效方法,熟练的操作技术、腹横筋膜的有效修复、人工材料和手术方法的合理选择是获得较好疗效的关键性因素。

Objective:To evaluate tension free hernioplasty with Prolene mesh in the treatment of adult inguinal hernia.Methods:From Jan1997to Aug2002,181cases of inguinal hernia were repaired by tension free hernioplasty.Essen tial methods included Rutkow procedure,Lichtenstein procedure,'sandwich'procedure and Gilbert procedure.Results:One hundred and eighty one patients underwent200repairs(Rutkow procedure,162;Lichtenstein procedure,10;sandwich procedure,11and Gilbert procedure,17).One patient died at the second postoperative day of cerebral hemorrhage;There were5cases of scrotal hematoma.One hundred and fifty cases were followed up for more than8months;Two had post operative neuralgia or chronic pain which was relieved later there.Conclusions:Tension free hernioplasty with Prolene mesh offers good therapeutic effect for all adult groin hernias.Appropriate choice of operative procedure and prosthetic material,together with skillful technique,results in satisfactory transverse fascia repair and good therapeutic results.